Treating College Students with Dialectical Behavioral Therapy

When a college freshman leaves home to attend a university, they are faced with many new stressors. Adjusting to not only the demands of academic life, but also the absence of normal family activity and a significant increase in independence can overwhelm a college student.

The isolation in these pressures can contribute to the problem as well. Many college students are unable to cope with the stress of college and exhibit symptoms of depression and borderline personality disorder (BPD). Students may also find themselves committing acts called nonsuicidal self-injurious (NSSI) behaviors, in which an individual may cut, burn or otherwise harm themselves to deal with stress.

For some students, the problems escalate until suicidal ideation and even suicide attempts become viewed as the only way to effectively deal with stress. College counseling centers are often available to students to seek help for addressing some of the pressures they face.

Many college counseling centers offer dialectic behavioral therapy (DBT). DBT is designed in such a way that the most critical and pressing issues are dealt with first, without dismissing the underlying emotions and problems that lead to those issues. DBT is effective at reducing critical symptoms in a short period of time and can be helpful in avoiding hospitalization or worsening of symptoms.

DBT can be a useful tool when treating college students dealing with suicidal ideation and suicide attempts. It incorporates elements of learning new skills, which are familiar aspects of life for a college student. In addition, the technique can be utilized by clinicians who are still training, which equates to lower costs and increased availability.

DBT is also flexible and can be adjusted according to the needs of the patient being treated.

A recent study by Jacqueline Pistorello of the Counseling Services Department at the University of Nevada examined the use of DBT as it compared to treatment as usual (TAU) among college students. The study involved 63 students being treated for NSSI, suicidal ideation, depression or BPD.

Each student was treated with DBT or with TAU during the course of the school year and then an assessment was performed at the end of treatment. Follow-ups were also conducted at three month intervals over the next 18 months.

The results showed that the students who received DBT exhibited a stronger improvement in symptoms when compared with those in the TAU group. The purity of treatment and maintenance of gains was also more consistent among those in the DBT treatment group.

Pistorello explains that the findings provide hope for college campuses struggling under budget cuts. DBT may be a very effective treatment provided at a very low cost for students struggling with significant mental health issues.

The findings are published in the Journal of Consulting and Clinical Psychology.